title: [Characteristics and factors associated with mortality in patients receiving mechanical ventilation: first Chilean multicenter study].
abstract: BACKGROUND
  The outcome of mechanically ventilated patients can be influenced by factors such as the indication of mechanical ventilation (MV) and ventilator parameters.
  
  
  OBJECTIVE
  To describe the characteristics of patients receiving MV in Chilean critical care units.
  
  
  METHODS
  Prospective cohort of consecutive adult patients admitted to 19 intensive care units (ICU) from 9 Chilean cities who received MV for more than 12 hours between September lst, 2003, and September 28th, 2003. Demographic data, severity of illness, reason for the initiation of MV, ventilation modes and settings as well as weaning strategies were registered at the initiation and then, daily throughout the course of MV for up to 28 days. ICU and hospital mortality were recorded.
  
  
  RESULTS
  Of 588 patients admitted, 156 (26.5%) received MV (57% males). Mean age and Simplified Acute Physiology Score-II (SAPS II) were 54.6+/-18 years and 40.6+/-16.4 points respectively The most common indications for MV were acute respiratory failure (71.1%) and coma (22.4%). Assist-control mode (71.6%) and synchronized intermittent mandatory ventilation (SIMV) (14,2%) were the most frequently used. T-tube was the main weaning strategy. Mean duration of MV and length of stay in ICU were 7.8+/-8.7 and 11.1+/- 14 days respectively. Overall ICU mortality was 33.9% (53 patients). The main factors independently associated with increased mortality were (1) SAPS II > or =60 points (Odds Ratio (OR), 10.5; 95% CI, 1.04-106.85) and (2) plateau pressure > or =30 cm H2O at second day (OR, 3.9; 95% CI, 1.17-12.97).
  
  
  CONCLUSIONS
  Conditions present at the onset of MV and ventilator management were similar to those reported in the literature. Magnitude of multiorgan dysfunction and high plateau pressures are the most important factors associated with mortality.
authors.affiliation: Departamento de Paciente Crítico Clínica Alemana de Santiago, Facultad de Medicina, Medicina Clínica Alemana-Universidad del Desarrollo, Santiago, Chile. vtomicic@alemana.cl
authors.forename: Vinko
authors.initials: V
authors.lastname: Tomicic
authors.forename: Mauricio
authors.initials: M
authors.lastname: Espinoza
authors.forename: Max
authors.initials: M
authors.lastname: Andresen
authors.forename: Jorge
authors.initials: J
authors.lastname: Molina
authors.forename: Mario
authors.initials: M
authors.lastname: Calvo
authors.forename: Héctor
authors.initials: H
authors.lastname: Ugarte
authors.forename: Jorge
authors.initials: J
authors.lastname: Godoy
authors.forename: Sergio
authors.initials: S
authors.lastname: Gálvez
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Maurelia
authors.forename: Iris
authors.initials: I
authors.lastname: Delgado
authors.forename: Andrés
authors.initials: A
authors.lastname: Esteban
mesh_terms: D000328:Adult; D002677:Chile / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration / Q000401:mortality; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy; D012121:Respiration, Artificial / Q000401:mortality*; D012128:Respiratory Distress Syndrome / Q000175:diagnosis; D012131:Respiratory Insufficiency / Q000401:mortality / Q000628:therapy*; D014505:Urban Population; D015300:Ventilator Weaning / Q000706:statistics & numerical data